Nobuyuki Ohguro

　　Department of Ophthalmology，Osaka University Medical School 100044

　　Historically，corticosteroids were first applied to ophthalmic practice in 1950.Since then，corticosteroids remain the mainstay of management of ocular inflammatory and immune-mediated disease.However，sometimes we met cases refractory to enough systemic corticosteroid treatment.In such cases，we have to consider Masquerade syndromes。

　　Masquerade syndromes are defined as a group of disorders characterized by the presence of intraocular cells secondary to non-immune-mediated inflammatory diseases，such as malignancies or infectious diseases.They are often misdiagnosed as chronic idiopathic uveitis.The diagnosis and treatment of Masquerade syndromes is the most challenging entities for uveitis specialists。

　　On the other hand，even in immune-mediated uveitis patients，systemic corticosteroids are sometimes insufficient to control the inflammation and in others，side effects of corticosteroids result in the need for a corticosteroid-sparing agent.In these situations，immunosuppressive and biologic agents play an important role in the management of patients with non-infectious inflammatory disease。

　　In my part of this symposium，I would like to show several cases refractory to corticosteroid treatment and discuss about the diagnosis and treatment of these cases.